Veress needle versus direct trocar entry for laparoscopy: a  retrospective study

Sinha, Sushma; Malik, Sanju

doi:10.18203/2320-1770.ijrcog20185407

Cited by 7 publications

(7 citation statements)

References 7 publications

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“…Pneumoperitoneum creation by Veress needle insertion, insuflation and trocar introduction takes longer than direct introduction of trocar where in the steps to create pneumoperitoneum are reduced and hence the time. The similar findings were reported by Issam Merdam et al 15 and Sushma sinha et al 16 (Table-1). The intraoperative complications (Table-2) encountered in group A and B included omental emphysema (7.95% vs 0.8%) as predominant complication in group A followed by preperitoneal insufflation (5.19% Vs 0%).…”

Section: Discussionsupporting

confidence: 90%

“…The post-operative complications (table-3) included subcutaneous emphysema (3.36% vs 0), port site infection (4.28% vs1.2%), port site echymosis (1.84% vs 0) in group A and B. Similar findings were seen by Issam Merdam et al 15 , Sushma sinha et al 16 , Prieto-Díaz-Chávez E et al 17 , zakerah et al 18 Among post-operative complications Port site infection, Port Site Echymosis, Subcutaneous Emphysema were statistically significant (Table-3, Figure 4).…”

Section: Discussionsupporting

confidence: 81%

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Classical Closed Technique by Veress Needle Insertion Versus Direct Trocar Insertion in the Creation of Pneumoperitoneum in Various Laparoscopic Surgeries

Mushtaq¹,

Naikoo²,

Gilkar³

et al. 2019

IJCMR

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Introduction: Laparoscopy has revolutionised Surgery with its widespread acceptance as predominantly minimally invasive to intraabdominal surgical procedures. Creation of pneumoperitoneum is indispensable primary step of the procedure as it allows creation of operative field. It can be achieved by various techniques viz Classical open method as described by Hasson. The aim of the study was to ascertain safety of direct trocar insertion in creation of pneumoperitoneum in laparoscopic surgeries and adopt the same as an alternative to veress technique. Material and methods: A total of 576 patients were included in the study, Group A comprised of patients in whom we created pneumoperitoneum by classical veress needle insertion and included 327 patients. Group B comprised of 249 patients in whom we created pneumoperitoneum by direct trocar insertion method. Results: The mean age of patients was 47.54 years SD 11 with a male female ratio of 1:1.56. Laparoscopic cholecystectomy (52.08%) was most frequent followed by laparoscopic appendectomy (13.02%). Group A patients witnessed omental emphysema (7.95%) as commonest complication followed by preperitoneal insufflation(5.19%) while as the most common complication in group B was omental emphysema (0.81%). Port site infection (4.28%) and subcutaneous emphysema (3.36%) predominated in group A and port site infection (1.2%) and seroma formation (1.2%) were common in group B. Conclusion: There are many methods to create pneumoperitoneum. The closed technique modified to direct trocar insertion versus classical method by Veress were compared in patients undergoing laparocopic procedures at SMHS hospital for a period of one and a half year. The results are fascinating as the modified technique overshadows its classical version in terms of feasibility, efficacy and consumption of time.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 81%

Classical Closed Technique by Veress Needle Insertion Versus Direct Trocar Insertion in the Creation of Pneumoperitoneum in Various Laparoscopic Surgeries

Mushtaq¹,

Naikoo²,

Gilkar³

et al. 2019

IJCMR

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“…In todays, era of laparoscopic surgery, despite numerous recent technical advances in minimally invasive surgery, the potential exists for serious morbidity during initial laparoscopic access. Safe access depends on adhering to well-recognized principles of trocar insertion, knowledge of abdominal anatomy, and recognition of hazards imposed by previous surgery [12] . Creation of the pneumoperitoneum is the first and most critical step of a laparoscopic procedure because that access is associated with injuries to the gastrointestinal tract and major blood vessels and at least 50% of these major complications occurs prior to commencement of the intended surgery [13] .…”

Section: Discussionmentioning

confidence: 99%

“…The existence of numerous techniques for creation of pneumoperitoneum at laparoscopy indicates that none has been proven totally efficacious or complication free. These methods include the standard technique of insufflation by insertion of the Veress needle, open laparoscopy, optical trocar, and direct trocar entry without prior pneumoperitoneum [14] . It was noted that complications of laparoscopic surgery are mostly entry-related and independent of the complexity of surgery.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of direct trocar entry versus Veress needle entry for laparoscopic surgery

Basa¹,

Gudur²

2021

Int. J. Surg. Sci.

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Introduction: Laparoscopy has revolutionised Surgery with its widespread acceptance as predominantly minimally invasive to intraabdominal surgical procedures. Laparoscopy is the art of examining the abdominal cavity and its contents. It requires insertion of a cannula through the abdominal wall, distention of the abdominal cavity with gas or air (pneumoperitoneum), and visualization and examination of the abdomen's contents with an illuminated telescope. Material and Methods: This is a prospective and observational study conducted in the Department of General Surgery at Prathima Institute of Medical Sciences over a period of 1 year. All the cases who underwent laparoscopic tubal ligation procedure during this time were taken into account. The traditional technique of Veress Needle entry (Group A) and Direct trocar entry (Group B). Inclusion Criteria: Patients which are posted for planned laproscopic surgeries irrespective of age and sex. Exclusion Criteria: Emergency surgeries. ▪ Patients having abdominal scars crossing umbilicus. ▪ Immunocompromised patients ▪ Seropositive patients. Result: In our present study, a total of 90 patients were included in both the groups out of which 21 (23.4%) were males and 69 (76.6%) were females in Group A and in Group B: 19 (21.1%) were males and 71 (78.9%) were females. The mean time taken to create Pneumoperitoneum in case of Veress Needle entry was 4 min 01 sec, of which maximum was 7 min 10 sec and minimum was only 3 min 05 sec. The mean time taken to create Pneumoperitoneum in case of Direct trocar entry was 1 min 43 sec, of which maximum was 3 min 20 sec and minimum was 1 min 15 sec. Complications arising during procedures were identified and recorded. Group A patients 6 patients witnessed omental emphysema was commonest complication followed by 5 patients preperitoneal insufflation while as the most common complication in group B was omental emphysema in 2 patients. Conclusion: Direct Trocar entry is a safe alternative to the Veress needle entry technique for the creation of pneumoperitoneum. One of the main advantages of this technique is the reduced number of the blind insertions required to gain abdominal access. Other benefits are rapid creation of pneumoperitoneum, less gas use and decreased operating time. In laparoscopic surgeries, it is a more reliable and less timeconsuming method.

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“…24 In contrast to present study, Sinha et al documented significantly higher number of attempts in Veress needle group as compared to direct trocar insertion group. 25 Chavez et al also documented significantly higher number of failed attempts in Veress needle group as compared to direct trocar insertion group. 21 Both the techniques are safe and feasible for creation of pneumoperitoneum during laparoscopic procedure.…”

Section: Number Of Attemptsmentioning

confidence: 90%

A comparative study between direct safety trocar insertion versus veress needle technique for creating pneumoperitoneum in laparoscopic surgeries

Datey¹,

Jain²,

Patel³

2021

Int Surg J

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Background: There are two methods of trocar insertion in laparoscopic surgeries one is direct insertion and second is Veress needle insertion. In this study we compared these two methods.Methods: In this study we divided 50 patients equally into two group group A for in group A patients, direct trocar insertion technique was used for creation of pneumoperitoneum whereas amongst patients of group B, pneumoperitoneum was created using Veress needle insertion technique.Results: The incidence of visceral injuries, vascular injuries and other post-operative complications were similar in both the groups. The present study observed no significant difference in failure rates between two methods.Conclusions: Both the techniques i.e.; Direct trocar insertion (DTI) and Veress needle technique are equally effective, safe and feasible for creation of pneumoperitoneum during laparoscopic procedure.

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Veress needle versus direct trocar entry for laparoscopy: a retrospective study

Cited by 7 publications

References 7 publications

Classical Closed Technique by Veress Needle Insertion Versus Direct Trocar Insertion in the Creation of Pneumoperitoneum in Various Laparoscopic Surgeries

Classical Closed Technique by Veress Needle Insertion Versus Direct Trocar Insertion in the Creation of Pneumoperitoneum in Various Laparoscopic Surgeries

Comparative study of direct trocar entry versus Veress needle entry for laparoscopic surgery

A comparative study between direct safety trocar insertion versus veress needle technique for creating pneumoperitoneum in laparoscopic surgeries

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